Industry News

CMS Reporting Requirements: CMS Proposes Deadline for Self-Identified Overpayments

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule that will require providers and suppliers to report and refund self-identified overpayments either 60 days after the overpayment was identified, or on the date that any cost report is due (if applicable). These CMS reporting requirements will only allow providers to use the cost report time frame if the overpayment usually would be reconciled on the cost report.  Providers and suppliers who fail to meet the deadline may be subject to liability under the False Claims Act.

Under the proposed rule, provider and suppliers are responsible for identifying and refunding all overpayments they discover within 10 years of receipt of the overpayment.  CMS established a 10-year lookback period to be consistent with the False Claims Act.  This period will also further the agency’s mission to recover improper payments from providers and suppliers.
CMS is accepting comments on its proposed rule until April 16.

The proposed rule on reporting and refunding overpayments is available at:

Centers for Medicare & Medicaid Services.  Medicare Program; Reporting and Returning of Overpayments, 77 Fed. Reg. 32, 9179, 9187 (Feb. 16, 2012).